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[Dyspnea attack due to hysteria after general anesthesia]
1Department of Anesthesiology, Jikei University School of Medicine, Tokyo.
Masui. the Japanese Journal of Anesthesiology
|June 10, 2000
Summary
This case study highlights recurrent dyspnea attacks in a patient undergoing breast reconstruction. Psychological evaluation diagnosed hysteria, suggesting a non-organic cause for the respiratory distress.
Area of Science:
- Anesthesiology
- Psychiatry
- Plastic Surgery
Background:
- A 30-year-old female experienced recurrent episodes of dyspnea following various stages of breast reconstruction surgery.
- These episodes occurred after procedures involving local anesthesia, general anesthesia, and post-operative recovery periods.
Observation:
- Initial dyspnea post-local anesthesia required intubation and mechanical ventilation.
- Subsequent episodes of dyspnea occurred after general anesthesia and extubation, managed with midazolam and deep sedation.
- Apnea monitoring was employed after a debridement and resuture operation due to a nocturnal dyspnea attack.
Findings:
- Psychological testing, including CMI and MMPI, led to a diagnosis of hysteria.
- The patient's respiratory symptoms were intermittent and appeared to correlate with surgical and anesthetic interventions, but lacked clear organic pathology.
Implications:
- This case underscores the importance of considering psychological factors, such as hysteria, in the differential diagnosis of unexplained post-operative dyspnea.
- Multidisciplinary assessment involving anesthesiology, surgery, and psychiatry is crucial for managing complex patient presentations.
- Further research into the psychosomatic aspects of post-surgical respiratory distress may improve patient care and outcomes.